NPIMap

Organization Active NPI

A Center for Human Development LTD

  • Clinical Social Worker
  • Dover, DE
National Provider Identifier
1174559918
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0000180 Issued in DE
Legal business name
A CENTER FOR HUMAN DEVELOPMENT LTD
Practice address
148 S. Bradford St.
Dover, DE 19904
Phone
(302) 736-1820
Fax
(302) 736-5016
NPI assigned
Jun 23, 2006
Last updated
Jan 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Russell Widder, LCSWNPI 1336172386
Title
Owner
Phone
(302) 736-1820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC-0000004 DE
Clinical Social Worker 1041C0700X Q1-0000249 DE
Clinical Social Worker 1041C0700X Q1-0000503 DE
Clinical Social Worker 1041C0700X Q1-0000831 DE
Clinical Social Worker 1041C0700X Q1-0000180 DE Primary

Addresses

Primary practice location

148 S. Bradford St.
Dover, DE 19904

Mailing address

148 S. Bradford St.
Dover, DE 19904
Phone (302) 736-1820

Other identifiers 1

IdentifierTypeStateIssuer
1000032300MedicaidDE

National Provider Directory

National Provider Directory

Locations

148 S Bradford St
Dover, DE 19904
Phone (301) 736-1820

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1174559918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 S. BRADFORD ST.",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19904",
            "telephone_number": "302-736-1820",
            "fax_number": "302-736-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S. BRADFORD ST.",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "19904",
            "telephone_number": "302-736-1820",
            "fax_number": "302-736-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CENTER FOR HUMAN DEVELOPMENT LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "WIDDER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-736-1820",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "PC-0000004",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000249",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000503",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000831",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000032300",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.